Reema Health·Grand Rapids, Michigan
Engage and support members with severe mental illness and substance use disorders to enroll them in care models and achieve wellbeing goals. Coordinate referrals, manage a caseload of 80-100 members, and provide in-person community outreach and support.
Provide high quality and meaningful support to members to achieve improved health and wellbeing outcomes:
Through cold outreach create and manage a caseload of 80 - 100 members and provide coverage for other Community Guides during periods of absence or increased workload.
Assess member needs and support systems, including social determinants of health, to help create a patient-centered care plan.
Assess member behavior and mental health needs and actively participate in guiding them through the process of enrolling in behavioral and mental health services.
Establish trusting relationships with members, reliably provide meaningful and quality support, and follow-through in a timely and appropriate manner to achieve their wellbeing goals.
Collaborate with our clinicians by helping patients connect to care, joining clinical visits as appropriate, following up on social needs.
Coordinate referrals and support appointment scheduling and attendance with behavioral health, primary care, and other provide types for members.
Understand overall goals for the month. Independently organize and prioritize workload with effective time and task management skills to achieve monthly goals and outcomes.
Actively listen, empathize, and appreciate the vulnerability of members willing to share their challenges. Community Guides will maintain professional boundaries and confidentiality, seeking consultation and support with complex member situations from the multidisciplinary team.
Visit members in person as appropriate. This may be in the member’s home, community, the hospital or other treatment setting to build trust and maintain connection with Reema’s clinical services.
Utilize text, phone, email and face-to-face interactions appropriately to match your communication approach with each members’ preference and situation.
Effectively identify and connect members to community and health resources to support member needs. This may include transporting members and accompanying them to access other services. Establish relationships with resources to support Reema’s members as needed.
Prepare members for services ending by keeping self-sufficiency and independence top of mind.
Complete accurate and thorough documentation and record keeping in a timely manner:
Utilize the Reema App to thoroughly document all work with members in a timely fashion, including keeping a care plan updated.
Understand and comply with confidentiality of protected health information and HIPAA.
Support member records to be thorough and accurate in both Reema’s technology and our EHR.
Work independently and collaboratively in a fast-paced startup environment. See frequent change as an opportunity rather than a barrier.
Serve diverse members in your community with dignity and respect, as well as build relationships with community resources and customers.
Partner with Reemates across the multidisciplinary team and the company to offer your perspective and learn from others.
Job responsibilities to grow and change as business necessitates.
As an equal opportunity employer, Reema Health is committed to a diverse workforce. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin, gender, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job-related characteristics or other prohibited grounds specified in applicable federal, state and local laws.
Reema Health has reviewed this job description to ensure that essential functions and basic responsibilities have been included. It is intended to provide guidelines for job expectations and assess the prospective employee and/or current employees ability to perform the position described. It is not intended to be interpreted as an exhaustive list of all functions, responsibilities, skills, and abilities for this role. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Requires a Bachelor's degree in Social Work, Psychology, or related fields, or equivalent experience, with at least 3 years of direct community experience. Must have a valid driver's license, reliable transportation, and proficiency in basic office technology.
Market context
Behavioral health openings in Michigan often draw steady interest because employers need independently licensed clinicians who can provide consistent weekly availability. For this LMSW role, competition may center on licensure status, schedule flexibility, and readiness to meet a 25-session, 30-hour weekly commitment. Review the AI-summarized requirements and benefits here to save time versus reading the full posting, then confirm your Michigan licensure and availability before applying.